Acneiform eruption induced by molecularly targeted agents in antineoplastic therapy: A review

Abstract

Background Various biologic agents targeting specific molecules present new treatment options for various tumors. Acneiform eruption is a very common skin reaction to these agents. Although not life‐threatening, acneiform eruption can affect patients' emotional and social lives. In very exceptional cases, it can lead to cancer therapy interruption. Aims The aim of this study was to review the incidence rate, clinical characteristics, pathogenesis, and current management of acneiform eruption induced by molecularly targeted agents. Methods This review was carried out through PubMed, Embase, and Cochrane searching terms ‘acneiform eruption’, ‘papulopustular eruption’ or ‘acne‐like rash’ and ‘skin toxicity’, ‘cutaneous toxicity’, ‘skin reactions’, ‘dermatological toxicities’, ‘target therapy,’ or ‘drug therapy’. Results Of the 73 articles matched our search terms, 61 were original articles and 12 were case reports or case series. Acneiform eruption is most commonly observed in patients treated with epidermal growth factor receptor inhibitors and mitogen‐activated protein kinase inhibitors. Typical lesions consist of erythematous papules and pustules without comedones, accompanying with burning, pruritus, or xerosis. The pathogenesis involves inflammation and abnormalities of the follicular epithelium, where a disorder in EGFR signaling plays a key role. The treatment of acneiform eruption depends on the severity of the rash. Conclusions Early recognition and effective management of this cutaneous adverse reaction can prevent unnecessary reduction and discontinuation of drug use and improve patient survival and quality of life. Close collaboration between oncologists and dermatologists is important to optimize therapy and improve patient survival.

Dasatinib-Associated Acneiform Eruption Successfully Treated With Sarecycline in a Patient With Chronic Myeloid Leukemia

“…Due to the clinical examination and temporal pattern, he was diagnosed with an acneiform eruption secondary to dasatinib use. His presentation was congruent with previously reported acneiform eruptions associated with multikinase inhibitors, which typically cause a papulopustular rash on the face and upper trunk within eight weeks of medication initiation [ 4 ]. At the time of rash onset, he was not taking any other daily medications, and no other new medications were started within at least the prior four months.…”

Mechanism of action of adapalene for treating EGFR‐TKI‐induced skin disorder

“… 3 It is also known that the severity of EGFR‐TKI‐induced skin rashes are dose‐dependent, with increased drug exposure leading to increased incidence and severity. 4 It is important to control skin disorders since they can hinder further EGFR‐TKI treatment.…”